Organization
KENNEWICK GENERAL HOSITAL
Active
Organization
KENNEWICK GENERAL HOSITAL
Active
Other names
The Pharmacy at Trios Southridge
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PORTER (PHCY MANAGER)
(509) 221-7351
Entity
Organization
Contact information
Practice address
521 N YOUNG ST, KENNEWICK, WA 99336-7806
(509) 221-6150
(509) 221-6151
Mailing address
3730 PLAZA WAY, KENNEWICK, WA 99338-2718
(509) 221-6150
(509) 221-6151
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF000056883
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2107413
PK
—
05
—
6025795
—
WA
Enumeration date
04/09/2007
Last updated
09/14/2016
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